Provider Demographics
NPI:1982959227
Name:O'NEAL, PATRICK WAYNE (ATC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:WAYNE
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3612
Mailing Address - Country:US
Mailing Address - Phone:864-597-4449
Mailing Address - Fax:864-597-4484
Practice Address - Street 1:429 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3612
Practice Address - Country:US
Practice Address - Phone:864-597-4449
Practice Address - Fax:864-597-4484
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11642255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer